慢性阻塞性肺疾病患者的歌唱肺健康：一项在线传递的多中心随机对照试验。

Singing for lung health in COPD: a multicentre randomised controlled trial of online delivery.

机构信息

National Heart and Lung Institute, Imperial College London, London, UK

Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK.

出版信息

BMJ Open Respir Res. 2024 May 2;11(1):e002365. doi: 10.1136/bmjresp-2024-002365.

DOI:10.1136/bmjresp-2024-002365

PMID:38697677

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11086531/

Abstract

BACKGROUND

Singing for lung health (SLH) is an arts-based breathing control and movement intervention for people with long-term respiratory conditions, intended to improve symptoms and quality of life. Online, remotely delivered programmes might improve accessibility; however, no previous studies have assessed the effectiveness of this approach.

METHODS

We conducted an assessor-blind randomised controlled trial comparing the impact of 12 weeks of once-weekly online SLH sessions against usual care on health-related quality of life, assessed using the RAND 36-Item Short Form Health Survey (SF-36) Mental Health Composite (MHC) and Physical Health Composite (PHC) scores.

RESULTS

We enrolled 115 people with stable chronic obstructive pulmonary disease (COPD), median (IQR) age 69 (62-74), 56.5% females, 80% prior pulmonary rehabilitation, Medical Research Council dyspnoea scale 4 (3-4), forced expiratory volume in 1 s % predicted 49 (35-63). 50 participants in each arm completed the study. The intervention arm experienced improvements in physical but not mental health components of RAND SF-36; PHC (regression coefficient (95% CI): 1.77 (95% CI 0.11 to 3.44); p=0.037), but not MHC (0.86 (95% CI -1.68 to 3.40); p=0.504). A prespecified responder analysis based on achieving a 10% improvement from baseline demonstrated a response rate for PHC of 32% in the SLH arm and 12.7% for usual care (p=0.024). A between-group difference in responder rate was not found in relation to the MHC (19.3% vs 25.9%; p=0.403).

DISCUSSION AND CONCLUSION

A 12-week online SLH programme can improve the physical component of quality of life for people with COPD, but the overall effect is relatively modest compared with the impact seen in research using face-to-face group sessions. Further work on the content, duration and dose of online interventions may be useful.

TRIAL REGISTRATION NUMBER

NCT04034212.

摘要

背景

歌唱疗法（SLH）是一种基于艺术的呼吸控制和运动干预方法，适用于患有长期呼吸系统疾病的人群，旨在改善症状和生活质量。在线远程提供的方案可能会提高可及性；然而，以前没有研究评估过这种方法的效果。

方法

我们进行了一项评估者盲法随机对照试验，比较了 12 周每周一次的在线 SLH 课程与常规护理对健康相关生活质量的影响，使用 RAND 36-Item 短期健康调查（SF-36）心理健康综合评分（MHC）和身体健康综合评分（PHC）进行评估。

结果

我们纳入了 115 名稳定的慢性阻塞性肺疾病（COPD）患者，中位（IQR）年龄 69（62-74）岁，56.5%为女性，80%曾接受过肺康复治疗，英国医学研究理事会呼吸困难量表 4 级（3-4 级），用力呼气量占预计值的百分比为 49（35-63）%。每组各有 50 名参与者完成了研究。干预组在 RAND SF-36 的身体健康部分而不是心理健康部分有改善；PHC（回归系数（95%置信区间）：1.77（95%置信区间 0.11 至 3.44）；p=0.037），但 MHC 没有改善（0.86（95%置信区间 -1.68 至 3.40）；p=0.504）。基于从基线提高 10%的预设应答者分析，在 SLH 组中，PHC 的应答率为 32%，而常规护理组为 12.7%（p=0.024）。在 MHC 方面，两组之间的应答率差异没有统计学意义（19.3%比 25.9%；p=0.403）。